Physician Compare National (NPI:1245530260)

HEALTHCARE PROVIDER: BETH ANNE PRALL CRNA

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1245530260
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	2567631757
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20120622000425
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	PRALL
	Individual professional last name
Provider First Name	BETH
	Individual professional first name
Provider Middle Name	A
	Individual professional middle name
Provider Gender	F
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	OTHER
	Individual professional's medical school
Graduation Year	2010
	Individual professional's medical school graduation year
Primary Specialty	CERTIFIED REGISTERED NURSE ANESTHETIST (CRNA)
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Organization Legal Name	DISTRICT MEDICAL GROUP INC
	Legal name of the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Group Practice PAC ID	7315086691
	Unique Group Practice ID assigned by PECOS to the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Number of Group Practice members	323
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	2601 E ROOSEVELT ST
	Group Practice or individual's line 1 address
City	PHOENIX
	Group Practice or individual's city
State	AZ
	Group Practice or individual's state
Zip Code	850084973
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Professional Accepts Medicare Assignment	Y